Allen v. Jeffreys

IN THE UNITED STATES DISTRICT COURT

FOR THE SOUTHERN DISTRICT OF ILLINOIS

KEITH ALLEN, M21830, )

)

Plaintiff, )

)

vs. )

)

WEXFORD HEALTH SOURCES, INC., ) Case No. 23-cv-3775-DWD

ANTHONY WILLS, )

ANGELA CRAIN, )

ALISA DEARMOND, )

N. FLORENCE, )

N. YOUSUF, )

KELLY PIERCE, )

JILLIAN CRANE, )

)

Defendants. )

MEMORANDUM AND ORDER

DUGAN, District Judge:

Plaintiff Keith Allen, an inmate of the Illinois Department of Corrections (IDOC)

brought this action pursuant to 42 U.S.C. § 1983 for alleged deprivations of his

constitutional rights. Specifically, he alleged that the defendants failed to treat or delayed

treatment for a hand injury he sustained during a fight in August of 2021. Defendant

Florence has moved for judgment on the pleadings, or alternatively, for summary

judgment on the exhaustion of administrative remedies. (Docs. 83, 84). Plaintiff has

responded (Doc. 92) and has also filed a few miscellaneous motions (Docs. 93, 94, 95). As

explained in this Order, Defendant Florence’s Motion (Doc. 83) will be denied, and this

matter will now proceed to full merits discovery on all claims against all defendants.

BACKGROUND

Here, the Court will limit the factual overview to the assertions relevant to

Defendant Florence. Plaintiff injured his hand on August 16, 2021, while defending

himself during a fight. On August 17, 2021, Plaintiff saw Defendant Crane (a nurse

practitioner) who gave him and ice pack and pain medication. (Doc. 1 at 18). On August

20, 2021, Crane saw Plaintiff a second time and he had an x-ray due to discoloration of

his right hand and visible swelling. (Doc. 1 at 20). Crane and Defendant Dearmond

believed the x-ray showed no fracture or break.

On August 20, 2021, Crane also sent the x-ray films to an outside radiologist—

Defendant N. Florence—for evaluation. (Doc. 1 at 21). Plaintiff alleges that Florence

determined the films were unremarkable. (Doc. 1 at 21). He argues that this assessment

was incorrect, because his hand was actually broken. He further alleges that the

misdiagnosis delayed or denied him access to further care. (Id.). He claims that Florence

reached this conclusion despite knowing of his severe hand injury and ongoing pain.

Plaintiff further alleged that Florence’s conduct was negligent, and that it constituted an

intentional infliction of emotional distress. (Doc. 1 at 22-23).

In the Order of Initial Review (Doc. 11), the Court allowed three claims against

Florence:

Claim 1: Eighth Amendment deliberate indifference claim against

Defendants J. Crane, Alisa Dearmond, N. Florence, and N.

Yusuf concerning their handling of his right-hand injury as

medical professionals;

Claim 4: State law medical negligence claim against Defendants J.

Crane, Alisa Dearmond, N. Yousuf, and N. Florence for their

early handling and diagnosis of Plaintiff’s injury;

Claim 5: State law intentional infliction of emotional distress claim

against all Defendants.

(Doc. 11 at 12). Plaintiff was allowed to proceed on additional claims, and all additional

claims and claims listed above against other defendants, are awaiting the opening of

merits discovery.

FINDINGS OF FACT

A. Judgment on the pleadings

Plaintiff’s medical records submitted with the Complaint (and again in response

to the recent motions) reflect that he had x-rays in August and September of 2021. On

August 26, 2021, Dr. Florence reported no evidence of an acute fracture or malalignment,

and no other remarkable characteristics. (Doc. 1-1 at 29). The x-ray films were stamped

as received on August 31, 2021, and as reviewed by an M.D. on September 7, 2021. (Doc.

1-1 at 29). On September 7, 2021, Defendant Crane completed a radiology summary form

that indicated the results were “normal or stable.” (Doc. 1-1 at 35). In the interim,

Plaintiff’s medical chart also indicated he got a second x-ray on August 31, 2021. (Doc. 1-

1 at 28). On September 2, 2021, Dr. Yousuf reported no sign of fracture or abnormality,

but suggested, “[i]f symptoms persist or progress, a follow-up study may be considered.”

(Doc. 1-1 at 32). On September 14, 2021, Plaintiff had a third x-ray. (Doc. 1-1 at 36). On

September 16, 2021, Dr. Yousuf noted mild degenerative changes, but no acute fracture

or dislocation. He noted mild swelling, but again stated a follow-up could be considered

if symptoms persisted or progressed. (Doc. 1-1 at 38). The results were stamped as

received October 5, 2021, and as reviewed by an M.D. on October 13, 2021. (Doc. 1-1 at

38). Ultimately, Plaintiff was seen by the Orthopaedic Institute of Southern Illinois on

February 8, 2022, at which time x-ray films were taken and revealed “an old fracture at

the base of the 5th metacarpal [that] was impacted, but it was healed.” (Doc. 1-1 at 63).

B. Exhaustion of administrative remedies—grievance records

On October 15, 2021, Plaintiff submitted a grievance about his right-hand injury

that he designated as an emergency. (Doc. 1-1 at 39-40). The Warden approved

emergency handling of the grievance, which was assigned number 232-10-21. (Id.). In

the grievance Plaintiff explained that he injured his hand and immediately experienced

severe visible swelling. He made requests to nurses during cellhouse rounds for

assistance, and he was ultimately seen a few days after his injury by a nurse practitioner

(Defendant Crane). Crane ordered an x-ray, and gave pain medication, and in

subsequent weeks, Plaintiff ultimately had three x-rays that all revealed no damage. His

severe pain persisted. At the time of writing the grievance, he indicated he was still in

serious pain, and he sought an x-ray and MRI from an outside provider, as well as

additional medication for the pain. He claimed that without intervention, he was

suffering ongoing pain in violation of the Eighth Amendment, inflicted by “Menard staff,

correctional officers, health care personnel, nurses, LPNs, doctors, Wexford Health Care

providers Inc., the assistant warden, director of operations, chief administrative officer

(warden), John Doe staff, etc.” (Doc. 1-1 at 39-40).

In response, the healthcare unit administrator indicated that Plaintiff had

undergone x-rays on August 20, 2021, and August 31, 2021, and he was scheduled to

review the results of the latter x-ray and possible future treatment. (Doc. 92 at 15, 18).

Based on this report, the grievance officer recommended denying the grievance as moot,

and the Chief Administrative Officer (CAO) concurred on November 10, 2021. (Doc. 92

at 15, 18). Plaintiff timely appealed to the Administrative Review Board (ARB). The ARB

deemed the grievance “mixed” given that an appointment was pending. (Doc. 92 at 19).

Plaintiff submitted a second emergency grievance about his hand on November 3,

2021. (Doc. 1-1 at 45-46). The Warden expedited it for emergency processing, and it was

assigned number 95-11-21. (Doc. 1-1 at 45). In the grievance Plaintiff indicated he was

still awaiting a response for his first emergency grievance, and that his pain had

intensified without treatment. He blamed the “nurses, LPNs, staff members, COs, John

Doe staff, Wexford Health care medical provider personnel, Warden (Chief

administrative officer), assistant warden, director of operations, doctors, [and]

physicians” for violating his rights with the lack of treatment. On November 8, 2021, the

grievance officer labeled the grievance a duplicate of the first emergency grievance, and

on November 10, 2021, the Warden concurred with this finding. (Doc. 1-1 at 50). The

ARB rejected the grievance as a duplicate and because the events alleged were “not

submitted within the timeframe outlined in Department Rule 504.” (Doc. 1-1 at 51). The

ARB further noted, “date of incident is outside of 60 days.” (Id.).

On February 15, 2022, Plaintiff submitted a third grievance that was approved for

emergency processing and was assigned number 121-2-22. (Doc. 92 at 24-25). Plaintiff

alleged that on February 8, 2022, he was seen for his hand injury at an outside hospital

and was told his hand was broken. He alleged his hand had healed improperly, and that

he was also diagnosed with arthritis and carpal tunnel. Plaintiff indicated he desired

surgery and medication. He stated, “Wexford Health Care Services, Inc., staff nurses,

LPNs, in Menard C.C. who gave me 3 different x-rays within a 30 day period right after

I broke my hand all lied to me maliciously and misdiagnosed me when they told me the

x-rays they had conducted results came back negative with no broken bones where they

joked about it and I knew it was lie which the second opinion from the outside doctor

and LPN I seen on 2/8/22 confirmed.” He further alleged that the lack of diagnosis or

misdiagnosis caused him prolonged suffering and permanent disfigurement or damage,

which he attributed to “Menard’s staff and Wexford’s health care services provider, inc.

staff, medical staff, nurses, LPNs, doctors’ inadequate policies.” (Doc. 92 at 24-25).

In response, the healthcare unit administrator relayed notes from the orthopedic

specialist consistent with the notes quoted above in the facts about judgment on the

pleadings. (Doc. 92 at 26-27). Based on this report, the grievance officer recommended

the grievance be denied as moot, and the CAO concurred. The ARB denied the grievance

on March 30, 2022, as appropriately addressed by the prison, and because treatment is at

the discretion of the licensed medical providers. (Doc. 92 at 28).

CONCLUSIONS OF LAW

A. Legal Standards

Pursuant to Federal Rule of Civil Procedure 12(c), “[a]fter the pleadings are closed—

but early enough not to delay trial—a party may move for judgment on the pleadings.”

FED. R. CIV. P. 12(c). A motion for judgment on the pleadings is governed by the same

standard as a motion to dismiss for failure to state a claim under Rule 12(b)(6). Adams v.

City of Indianapolis, 742 F.3d 720, 727-28 (7th Cir. 2014). To survive a Rule 12(b)(6) motion

to dismiss, a complaint must “contain sufficient factual matter, accepted as true, to ‘state

a claim to relief that is plausible on its face.’” Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009)

(quoting Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007)); Wagner v. Teva Pharm. USA,

Inc., 840 F.3d 355, 357-58 (7th Cir. 2016). A reviewing court must draw all reasonable

inferences and facts in favor of the non-movant but need not accept as true any legal

assertions. Vesely v. Armslist LLC, 762 F.3d 661, 664-65 (7th Cir. 2014). “As in a Rule

12(b)(6) analysis, [the court's] review is limited to the pleadings; however, the court ‘may

take into consideration documents incorporated by reference to the pleadings,’ and ‘may

also take judicial notice of matters of public record.’” Milwaukee Police Ass'n v. Flynn, 863.

F.3d 636, 640 (7th Cir. 2017) (quoting United States v. Wood, 925 F.2d 1580, 1582 (7th Cir.

1991)).

Summary judgment is proper if there is no genuine issue as to any material fact

and the movant is entitled to judgment as a matter of law. FED. R. CIV. P. 56(a). In

determining a summary judgment motion, the Court views the facts in the light most

favorable to, and draws all reasonable inferences in favor of, the nonmoving party. Apex

Digital, Inc. v. Sears, Roebuck & Co., 735 F.3d 962, 965 (7th Cir. 2013) (citation omitted).

Courts generally cannot resolve factual disputes on a motion for summary judgment. See

Tolan v. Cotton, 572 U.S. 650, 656 (2014) (“[A] judge’s function at summary judgment is

not to weigh the evidence and determine the truth of the matter but to determine whether

there is a genuine issue for trial.”) (internal quotation marks and citation omitted).

However, when the motion for summary judgment pertains to a prisoner’s failure to

exhaust administrative remedies, the Seventh Circuit has instructed courts to conduct an

evidentiary hearing and resolve contested issues of fact regarding a prisoner’s efforts to

exhaust. Pavey v. Conley, 544 F.3d 739, 742 (7th Cir. 2008).1 After hearing evidence,

finding facts, and determining credibility, the court must decide whether to allow the

claim to proceed or to dismiss it for failure to exhaust. Wilborn v. Ealey, 881 F.3d 998, 1004

(7th Cir. 2018). The court is not required to conduct an evidentiary hearing if there is no

genuine dispute of material fact, and the determination is purely legal. See e.g., Walker v.

Harris, 2021 WL 3287832 * 1 (S.D. Ill 2021); Miller v. Wexford Health Source, Inc., 2017 WL

951399 *2 (S.D. Ill. 2017).

The Prison Litigation Reform Act (PLRA) provides that a prisoner may not bring

a lawsuit about prison conditions unless and until he has exhausted all available

administrative remedies. 42 U.S.C. § 1997e(a); Pavey, 544 F.3d at 740. “The exhaustion

requirement is an affirmative defense, which the defendants bear the burden of proving.”

Pavey v. Conley, 663 F.3d 899, 903 (7th Cir. 2011). For a prisoner to properly exhaust his

administrative remedies, the prisoner must “file complaints and appeals in the place, and

at the time, the prison’s administrative rules require.” Pozo v. McCaughtry, 286 F.3d 1022,

1 The Court’s ability to conduct Pavey hearings for evidentiary disputes on exhaustion was altered slightly

by the Supreme Court’s holding in Perttu v. Richards, 605 U.S. ____, 145 S.Ct. 1793 (June 18, 2025) (holding

that if a factual dispute on exhaustion is intertwined with a factual dispute that goes to the merits of the

underlying substantive claim, then a jury trial is required on the intertwined issue(s)). In the present case,

there is no Perttu intertwinement issue.

1025 (7th Cir. 2002). “[A] prisoner who does not properly take each step within the

administrative process has failed to exhaust state remedies.” Id. at 1024.

As an inmate in the IDOC, Plaintiff was required to follow the grievance process

outlined in the Illinois Administrative Code. 20 ILL. ADMIN. CODE § 504.800, et seq. (2017).

The regulations first require an inmate to file his grievance with his counselor within 60

days of the discovery of an incident, occurrence, or problem that gave rise to the

grievance. 20 ILL. ADMIN. CODE § 504.810(a). Administrative regulations require the

grievance “contain factual details regarding each aspect of the offender’s complaint,

including what happened, when, where, and the name of each person who is the subject

of or who is otherwise involved in the complaint.” 20 ILL. ADMIN. CODE § 504.810(c). If

the names of the individuals are unknown to the offender, he can still file the grievance

but “must include as much descriptive information about the individual as possible.” Id.

Further, the Seventh Circuit has held that an inmate is required to provide enough

information to serve a grievance’s function of giving “prison officials a fair opportunity

to address [an inmate’s] complaints.” Maddox v. Love, 655 F.3d 709, 722 (7th Cir. 2011).

If the complaint is not resolved through the counselor, the grievance may be

submitted to a grievance officer, who reports his or her findings and recommendations

in writing to the Chief Administrative Officer (CAO). 20 ILL. ADMIN. CODE § 504.830(e).

The CAO then provides the inmate with a written decision on the grievance. Id. If the

inmate is not satisfied with the CAO’s response, he can file an appeal with the IDOC

Director through the Administrative Review Board (ARB). 20 ILL. ADMIN. CODE §

504.850(a). The ARB must receive the appeal within 30 days of the date of the CAO’s

decision. Id. The inmate must attach copies of the responses from the grievance officer

and CAO to his appeal. Id. The ARB submits a written report of its findings and

recommendations to the Director, who them makes a final determination. 20 ILL. ADMIN.

CODE § 504.850(d), (e).

B. Analysis

1. Judgment on the pleadings

Defendant Florence argues that he is entitled to judgment as a matter of law

because Plaintiff’s complaint and the records submitted with it show that Florence only

reviewed the first of three x-ray films, and Florence’s findings were consistent with two

subsequent films. (Doc. 84). Based on his very limited involvement in Plaintiff’s

situation, and the two corroborating films after the August 26, 2021, assessment, he

argues that Plaintiff simply cannot establish deliberate indifference. He claims that

deliberate indifference requires something more than mere negligence, and something so

far afield it was not based on medical judgment. (Doc. 84 at 4-5). Plaintiff vehemently

contests Florence’s characterization of the situation, arguing at length that his injury was

serious, Florence was aware of his extreme pain and swelling, and Florence chose not to

act, thus depriving him of care or delaying care with an overall negative permanent

outcome.

Unlike Defendant Moldenhauer, who was able to argue in this case for judgment

as a matter of law based on a nuanced reading of the medical records appended to the

complaint (Doc. 90), Defendant Florence’s position is less compelling. The Court already

thoroughly reviewed and analyzed the allegations and evidence in this case at the initial

review stage under 28 U.S.C. § 1915A. The standard of review at that phase is akin to a

motion to dismiss, and thus it is also akin to the standard applicable to a motion for

judgment on the pleadings. The Court acknowledged in the Order of Initial Review (Doc.

11) that the evidence against some of the providers, including Florence, was thin but that

it was sufficient to proceed beyond initial review so that the factual record could be

further developed. While it is certainly plausible that Florence had a very singular and

remote role in this case, reviewing just a single set of films, the Court does not yet have

any evidence that defines the scope of his relationship to Menard healthcare staff, or the

information he had available to him at the time he reviewed the films. While Florence

alleges his actions were taken in complete isolation, Plaintiff alleges that Florence knew

more about his situation and had greater insight into his condition. Given that the parties

are still in opposition over facts that will better illuminate this claim, judgment on the

pleadings is inappropriate.

Florence also seeks dismissal of the intentional infliction of emotional distress

claim. Plaintiff argues the claim should survive because Florence knowingly and

intentionally falsified medical records concerning his x-ray and prevented him from

getting care or a proper diagnosis until six months later. (Doc. 92 at 20-22). While these

facts may not hold up at the merits summary judgment phase, for now, they are sufficient

to proceed with the other claims. As the Court previously indicated, if the primary

constitutional claim against Florence fails (Claim 1), the Court will relinquish

supplemental jurisdiction over related state law claims against Florence.

C. Exhaustion of administrative remedies

Defendant Florence argues that Plaintiff failed to exhaust administrative remedies

against him because his three relevant grievances were not properly processed at all

levels of the grievance system. Specifically, he argues that Plaintiff’s October 15, 2021,

grievance and his February 15, 2022, grievance, were both found to be appropriately

addressed by the Administrative Review Board, and Plaintiff did not appeal these

findings. (Doc. 84 at 7-8). As to the November 3, 2021, grievance, Florence argues that

the grievance was not filed in the correct timeframe, and Plaintiff did not appeal this

finding. Florence argues that Plaintiff did not specifically mention him in any of the

grievances, and he argues none of them were properly appealed.

Defendant Florence’s stance is perplexing. All three grievances were processed at

all levels of review within the available grievance system. Plaintiff initiated them at the

prison, they were reviewed by grievance officers and the Chief Administrative Officer,

and Plaintiff appealed them to the ARB. It is true that the November 3, 2021, grievance

was marked as out of timeframe, but it was also noted as purely duplicative of the

October 15, 2021, grievance. Perhaps Florence means to argue that because the grievances

were deemed appropriately addressed by prison staff and thus moot or satisfactory, then

Plaintiff has no cause to sue, but this is not how the IDOC grievance process functions.

There are instances when inmates attempt to argue that a favorable resolution at the

prison level means they do not have to go to the ARB level of review, but that is not the

situation in this case. Defendant Florence’s arguments that Plaintiff failed to exhaust the

grievances at all levels are entirely unavailing and must be rejected.

Alternatively, Florence argues that none of the grievances are sufficient to identify

him. This issue is a closer call. The IDOC grievance rules technically call for a description

of a person being grieved if their name is not known, but courts have taken a slightly

more lax approach and have allowed grievances that sufficiently notify the prison system

of the issue being grieved. Plaintiff repeatedly complained in his October 15, 2021,

grievance and again in his February 15, 2022, grievance that he had three x-rays, but none

of them adequately identified the source of his pain. He also complained in the

November 2021 grievance that it was a follow-up query on the October 15, 2021,

grievance which had been deemed an emergency, but had otherwise not been returned

to him. The contents of these grievances were adequate to notify the prison that he did

not believe he was getting satisfactory care for his injury, and that he attributed part of

the problem to the three early x-rays that failed to detect any issue.

While Plaintiff may not have known Defendant Florence’s name, Florence’s role

could have been easily identified by a review of Plaintiff’s medical records. The Seventh

Circuit and other judges in this District have found a grievance to be sufficient to exhaust

a claim if it is sufficiently detailed for the prison to identify and remedy an issue,

regardless of if it precisely names a particular medical provider or employee. See e.g.,

Jackson v. Esser, 105 F.4th 948, 959-60 (7th Cir. 2024) (the PLRA does not have a “name all

defendants” requirement, but the grievance must at least provide enough information

about the problem for the prison to reasonably investigate and resolve the issue); Maddox

v. Love, 655 F.3d 709, 721-22 (7th Cir. 2011) (a grievance can be sufficient without naming

a person if it fairly describes the underlying issue and thus gives the prison a chance to

rectify it); Glick v. Walker, 385 Fed. App’x 579, 582 (7th Cir. 2010) (grievances are intended

to give prison administrators a chance to address a shortcoming, not put individual

defendants on notice of a lawsuit); Bakaturski v. Brookhart, 2022 WL 1093633 (S.D. Ill. Apr.

12, 2022) (finding a grievance sufficient to exhaust a claim against a healthcare

administrator where she was not named, but conduct she participated in was described

in the grievances); but see Roberts v. Neal, 745 F.3d 232, 235-36 (7th Cir. 2014) (finding that

a grievance that singled out a doctor and made no mention of specific nurse, was not

sufficient for exhaustion against the nurse because it had nothing to do with her alleged

conduct). Here, Plaintiff’s grievances repeatedly spoke of the x-rays he had, one of which

was reviewed by Florence. The grievances were addressed by the prison on the merits,

which suggests they contained enough information for prison to be on notice of

underlying issues and those involved even if they were not individually named. As such,

the grievances are sufficient to exhaust the claim against Defendant Florence.

MISCELLANEOUS MOTIONS

On the same day that he filed his response to Defendant Florence’s Motion,

Plaintiff moved for the Court to take judicial notice and to accept a late filing (Doc. 93).

In the Motion he complains of alleged retaliation in various forms that he claims delayed

his ability to file his response. The Motion (Doc. 93) is GRANTED to the extent that

Plaintiff asks the Court to accept his response as timely. To the extent Plaintiff is

attempting to expand the bounds of this suit to include any retaliation allegations

described in the motion, any such effort is rejected as improper.

Plaintiff’s Motion for a Copy and Status (Doc. 94) is GRANTED in part. The

Motion is GRANTED as to the request for status on Florence’s Motion, and it is DENIED

to the extent that Plaintiff seeks a copy of document 33. As the Court previously

explained, copies are $0.50/page. Document 33 is 22 pages, so it would cost $11.00.

Plaintiff can get a copy by sending payment and a letter to the Clerk’s Office.

Finally, Plaintiff’s Second Motion for Status (Doc. 95) is GRANTED to the extent

he seeks an update on Defendant Florence’s Motion, and it is otherwise DENIED to the

extent he seeks to revive old motions for counsel or injunctive relief.

DISPOSITION

Defendant Florence’s Motion for Judgment on the Pleadings or Summary

Judgment on Exhaustion (Doc. 83) is DENIED.

Plaintiff’s Motion for Judicial Notice (Doc. 93) is GRANTED to the extent Plaintiff

asks the Court to accept Document 92 as timely, but it is otherwise DENIED to the extent

it seeks to expand claims. Plaintiff’s Motion for Status (Doc. 94) is GRANTED by the

issuance of this Order, and is DENIED as it pertains to the request for a courtesy copy.

Plaintiff’s Motion for Status (Doc. 95) is GRANTED in part as it pertains to Defendant

Florence’s Motion, but it is DENIED to the extent he seeks to revive old motions.

IT IS SO ORDERED.

Dated: July 11, 2025

/s David W. Dugan

______________________________

DAVID W. DUGAN

United States District Judge